CN117653453A

CN117653453A - Ileum fistulization pipe

Info

Publication number: CN117653453A
Application number: CN202310556156.7A
Authority: CN
Inventors: 赵国海; 赵军; 杜军; 赵迎春
Original assignee: Individual
Current assignee: Individual
Priority date: 2017-07-04
Filing date: 2017-07-04
Publication date: 2024-03-08
Also published as: CN107198604B; CN107198604A

Abstract

The invention provides an ileostomy tube which comprises a tube body and is characterized in that a first balloon (12) is arranged on the outer wall of the lower end of the tube body (1), an auxiliary balloon (15) is arranged on the upper portion of the first balloon (12) at the lower section of the tube body, a drainage hole (16) is formed in the outer wall of a section of the tube body between the auxiliary balloon (15) and the first balloon (12), and the drainage hole is communicated with a drainage cavity tube (6). The invention can further reduce the risk of intestinal fluid leaking to the anastomotic stoma.

Description

Ileum fistulization pipe

The application is a divisional application, the application date of the original application is 2017, 07 and 04, the application number is 2017105388411, and the name is an ileostomy tube.

Technical Field

The invention belongs to the technical field of medical appliances, and particularly relates to an ileostomy tube capable of blocking an intestinal cavity and preventing anastomotic leakage.

Background

Colorectal cancer is one of the most common malignant tumors of the digestive tract, and has the characteristics of high morbidity, high mortality rate and the like. Surgical resection is currently the most effective treatment for colorectal cancer. For a long time, the anastomotic stoma leakage after the low-level rectal cancer (the lower margin of the tumor is less than 7 cm from the anus) and the abdominal-rectal cancer anterior incision operation (Dxion) is one of the most serious and common postoperative complications, and the incidence rate is 10-20%. Although traditional colo-or ileal-terminal stomies have the efficacy of preventing and treating anastomotic leakage, later-stage stomy nanosurgery often places more burden and pain on the economy, flesh and spirit of the patient, and is suspected of overstreating for the vast majority of patients who do not experience anastomotic leakage.

In recent years, the field of surgery has invented a new ostomy, such as performing an appendiceal stump fistulization and a ileocecal catheterization, which can effectively reduce the incidence of anastomotic leakage, effectively avoid complications caused by a ileocecal stoma, and avoid re-operating the ileocecum tube. However, the 18-24 Foley catheters adopted in the catheterization are all flexible tubes, the tube diameter is small, the feces are not easy to pass through, the lumen of the catheter is easy to be narrow and obstructed, and the catheters are required to be repeatedly flushed with normal saline after the obstruction, so that inconvenience is brought to patients and medical staff. Therefore, there is a need for a new ileostomy tube that can prevent anastomotic leakage, does not increase patient trauma, and can prevent obstruction.

Disclosure of Invention

The invention aims at the problems and provides the ileostomy tube which can better prevent anastomotic leakage and prevent pipeline obstruction.

The ileostomy tube is characterized in that a first balloon is arranged on the outer wall of the lower end of the tube body, an auxiliary balloon is arranged on the upper portion of the first balloon at the lower section of the tube body, and a drainage hole is formed in the outer wall of a section of the tube body between the auxiliary balloon and the first balloon and communicated with a drainage cavity tube.

Compared with the prior art, the invention has the following beneficial effects:

1. in the invention, the auxiliary saccule is arranged besides the first saccule, and the drainage hole is arranged on the pipe body between the first saccule and the auxiliary saccule, so that the risk of intestinal juice leaking to the anastomotic stoma can be further reduced.

Drawings

Fig. 1 is a perspective view of embodiment 1 of the present invention.

FIG. 2 is a cross-sectional view (including a flush tube) of example 1 of the present invention.

FIG. 3 is a cross-sectional view (including a flush tube) of example 1 of the present invention.

Fig. 4 is an enlarged schematic view of fig. 3 (with a flush tube).

Fig. 5 is an enlarged schematic view of fig. 3 (with a flush tube).

Fig. 6 is a cross-sectional view of a flush tube of the present invention in a spiral shape.

Fig. 7 is a schematic representation of the invention in actual use.

Fig. 8 is a schematic view of the present invention with a plugging device (the plugging device is of a helical blade structure).

Fig. 9 is an enlarged schematic view of the handle position of fig. 8.

Fig. 10 is a schematic view of the handle.

FIG. 11 is a schematic view of a second stem and a clamping block and a helical blade.

FIG. 12 is a schematic illustration of the connection of the screw blade, the connection and the handle.

Fig. 13 is a schematic view of a connecting tube of the present invention.

FIG. 14 is a schematic view of a catheter tube of the present invention with a split port.

FIG. 15 is a schematic view of the present invention with a plugging device (the plugging device is in a pin configuration).

Fig. 16 is an enlarged schematic view of the position of the plugging device of the present invention (the plugging device is in a structure with a stirring pin).

Fig. 17 is a schematic view of the present invention after placement of an auxiliary balloon.

Reference numerals in the drawings: 1 catheter tube, 11 compression sheets, 12 first saccule, 121 first injection port, 122 first communication tube, 123 ligation distal end of first injection port, 13 second saccule, 131 second injection port, 132 second communication tube, 133 ligation distal end of second injection port, 14 split cavity port, 15 auxiliary saccule, 16 drainage hole, 2 drainage bag, 21 nail tail, 22 straight rod, 23 strip head, 3 flushing tube, 31 water outlet hole, 32 third injection port, 41 skin layer, 42 fat layer, 43 muscle layer, 44 peritoneum and fascia, 45 cecum, 46 appendix, 47 colon, 48 ileum, 49 ileocecum, 51 handle, 52 connecting part, 521 clamping block, 522 first connecting handle, 523 second connecting handle, 524 round hole, 53 helical blade, 54 connecting tube, 541 clamping protrusion, 55 stirring needle, 56 rubber plug, 6 drainage cavity tube, 7 control valve.

Detailed Description

The invention is described in further detail below with reference to the accompanying drawings.

Example 1: as shown in fig. 1 to 5, an adjustable ileostomy tube comprises a tube body 1, wherein the tube body 1 is a hose with openings at the upper end and the lower end, has a hardness of about 85A, and is resistant to bending and does not collapse easily. The lower end opening of the tube body is in an oblique incision shape, so that the tube body can be conveniently inserted into intestinal tracts during operation.

The upper section of the outer wall of the catheter tube 1 is provided with external threads and is connected with a pressing piece 11 through threads.

The outer wall of the catheter tube 1 is also sleeved with a first balloon 12 and a second balloon 13, and the first balloon 12 and the second balloon 13 are non-compliant balloons, so that air leakage is not easy to occur after filling.

The first saccule 12 is sleeved on the outer wall of the lower end of the catheter tube 1, the lower end of the first saccule 12 is cylindrical, the upper end of the first saccule is wavy, and the shape of the lower end of the first saccule 12 is matched with an oblique notch at the lower end of the catheter tube. By the arrangement, the first saccule 12 can be well matched with the lower end of the catheter tube body, so that the tip of the catheter tube body is prevented from being exposed, poked to the intestinal wall and uncomfortable feeling is prevented; meanwhile, the upper end is wavy, so that the balloon can be relieved from pressing the intestinal wall for a long time, and the probability of intestinal necrosis is reduced.

The second balloon 13 is of hemispherical or spherical structure and is sleeved on the outer wall of the catheter tube 1 between the first balloon 12 and the tabletting 11. The second balloon 13 is shown as a hemispherical shape with a planar configuration with respect to one side of the preform 11. The advantages are that: can better laminate human tissue, can laminate intestinal wall and abdominal wall together more effectively, promote adhesion. After adhesion, leakage of intestinal fluid into the abdominal cavity from there will no longer occur.

The upper section of the catheter tube 1 is provided with a first injection port 121 and a second injection port 131, the first injection port 121 is communicated with the first balloon 12 through a first communicating pipe 122 and is used for injecting or pumping water, and the second injection port 131 is communicated with the second balloon 13 through a second communicating pipe 132 and is used for injecting or pumping water. The first balloon 12 and the second balloon 13 can be inflated after the physiological saline is injected, and can be deflated after the water is pumped.

It should be noted here that the second balloon 13 and the tablet 11 may not be provided, the main functions of the second balloon 13 and the tablet 11 are to mutually cooperate, so that the intestinal wall is adhered to the abdominal wall and is adhered, and intestinal juice is prevented from leaking to the abdominal cavity.

Example 2: as shown in fig. 2, 3, 4 and 5, in order to solve the problem of obstruction of the dredging pipe body based on the embodiment 1, a flushing pipe 3 may be disposed in the pipe of the catheter pipe body 1, the lower end of the flushing pipe 3 is closed, and a plurality of water outlet holes 31 leading into the catheter pipe body 1 are disposed on a side wall of a lower section. A third injection port 32 is arranged at the upper section of the catheter tube 1, and the third injection port 32 is connected with the flushing pipe 3 and is used for injecting water or pumping water.

As shown in fig. 2 to 5, the shape of the flushing pipe 3 is a straight line, in fact, the flushing pipe 3 may be arranged in other shapes, as shown in fig. 6, the flushing pipe 3 is spiral, the arrangement is better than that of the straight line, because of the spiral design, the water outlet hole at the lower section can be circularly arranged, so that water can be sprayed from the periphery, and the flushing effect is better.

The positions of the first injection port 121, the second injection port 131 and the third injection port 32 are different from the distance of the upper end of the catheter tube 1, so that the connected components can be judged according to the difference of the distances between the injection ports and the tail ends, and corresponding marks can be made for identification.

As shown in fig. 7, the present invention is applied to the case of inserting the present invention into the abdomen of a human body after an intestinal surgery. Wherein 41 is the skin layer, 42 is the fat layer, 43 is the muscle layer, 44 is the peritoneum and fascia, 45 is the cecum, 46 is the appendix, 47 is the colon, 48 is the ileum, 49 is the ileocecal valve. The skin layer 41, fat layer 42, muscle layer 43, peritoneum and fascia 44 make up the abdominal wall. To prevent anastomotic leakage after colorectal segmental resection, an adjustable ileostomy catheter catheterization is available. The method comprises the following specific steps: after colorectal surgery, the terminal ileum is lifted out of the abdomen through an auxiliary small incision of the abdominal wall (endoscopic surgery) or a large incision of the middle and lower abdomen (open surgery), the intestinal wall is cut at a distance of 10 cm from the ileocecum, a catheter is inserted, the lower end of the catheter tube 1 is placed into the terminal ileum 48 through the ileocecum 49, and the placement depth is such that the second balloon 13 can be completely placed into the cecum cavity. Then, water is injected into the second balloon 13 through the second injection port 131 to prevent the catheter from slipping or shifting. Physiological saline is injected into the first balloon 12 through the first injection port 121, and the injection rate is adjusted according to the small intestine diameter so that the balloon is tightly adhered to the intestinal wall and the blood circulation of the intestinal wall is not affected (average about 15 mL). After the first saccule 12 is filled, the intestinal fluid can be blocked from flowing to the distal intestinal cavity, so that the intestinal fluid is led out of the body through the lower end of the catheter, the colon near the anastomotic stoma is kept in an empty, empty and unloaded state, and the normal healing of the anastomotic stoma is ensured. Finally, the second saccule 13 cooperates with the tabletting 11 arranged outside the body to enable the intestinal wall at the position where the catheter passes to be closely adhered to the abdominal wall, prevent intestinal juice from leaking to the abdominal cavity and fix the catheter. If the catheter tube is obstructed, physiological saline can be injected into the flushing tube 3 through the third injection port 32 for dredging. The upper end opening of the catheter tube body 1 can be connected with a drainage bag for recovering the intestinal juice of drainage and can also be connected with a negative pressure drainage device.

In order to facilitate the control of the opening of the upper end of the conduit, a control valve 7 can be connected to the opening of the upper end of the conduit. When the catheter is withdrawn after clinical evaluation, the first balloon 12 is evacuated of physiological saline to redirect intestinal fluid to the distal colorectal. Under the condition that the patient is not anastomotic stoma leakage and the physical sign is normal, the physiological saline in the second saccule 13 can be pumped out, the catheter can be easily pulled out, the leakage is plugged by using vaseline gauze, and the gauze is covered and the bellyband is pressurized and fixed. Changing the medicine after 3-4 days, removing the vaseline gauze, and covering the gauze after the leakage opening is basically healed.

Example 3: in example 2, the flushing pipe 3 is provided inside the catheter tube 1, and then the third injection port 32 injects water into the flushing pipe 3 to unblock an obstruction.

The embodiment provides a function of dredging obstruction by other structures, and the technical scheme is as follows:

as shown in fig. 8 to 13, on the basis of embodiment 1, the upper end opening of the catheter tube 1 is closed or connected with a control valve 7 by a silica gel plug.

The opening at the upper end of the catheter tube 1 is also detachably connected with a dredger, and the dredger comprises a handle 51, a connecting part 52, a spiral blade 53 and a connecting pipe 54 connected with the catheter tube 1. The connecting portion 52 and the connecting tube 54 are engaged with each other.

The inner wall of the connecting pipe 54 is provided with a clamping protrusion 541, the connecting portion 52 includes two clamping blocks 521, one of the clamping blocks is provided with a first connecting handle 522 with external threads, the other clamping block is provided with a second connecting handle 523, the second connecting handle 523 is provided with a round hole 524 with internal threads, and the round hole 524 is connected with the first connecting handle 522 through threaded fit. In actual assembly, two clamping blocks 521 are located on both sides of the clamping protrusion 541.

In this embodiment, when an obstruction is encountered, the dredger can be connected to the opening at the upper end of the catheter tube, the spiral blade 53 is inserted into the lumen, and then the handle 51 is rotated, so that the spiral blade 53 is driven to rotate the dredging tube. The presence of the clamping block 521 and the clamping protrusion 541 can prevent intestinal juice from flowing out during blocking.

Here, the dredge structure of the present embodiment may be used in combination with the flushing pipe 3 structure of embodiment 1, which is more effective.

In addition, as shown in fig. 14, a cavity opening 14 may be provided at the upper portion of the catheter tube 1, so that a Y-shaped cavity structure is formed at the upper portion of the catheter tube 1. The cavity opening 14 is connected with a drainage bag or a negative pressure drainage device so as to recycle the drained intestinal juice. By the arrangement, intestinal juice can be recovered by utilizing the cavity opening while dredging.

Example 4: embodiment 3 provides a dredge structure, and this embodiment provides a dredge of another structure.

As shown in fig. 15 and 16, the dredging device comprises a connecting pipe 54 detachably connected with the catheter tube 1 and a stirring pin 55, wherein a plurality of rubber plugs 56 with holes are arranged on the inner wall of the connecting pipe 54, the stirring pin 55 penetrates through the holes of the rubber plugs 56 and enters the catheter tube 1 to dredge obstruction, the rubber plugs 56 can prevent liquid from flowing out during dredging, and meanwhile, the stirring pin 55 can have a certain movable range.

Example 5: as shown in fig. 17, in order to reduce the risk of intestinal juice leaking to the anastomotic stoma as much as possible, an auxiliary balloon 15 may be further disposed between the first balloon 12 and the second balloon 13, the outer wall of a section of catheter tube between the auxiliary balloon 15 and the first balloon 12 is provided with a drainage hole 16, the drainage hole is communicated with the drainage cavity tube 6, the drainage cavity tube 6 is attached to the inner wall of the catheter tube 1 and extends from bottom to top, and penetrates out of the catheter tube 1 when reaching the upper section of the catheter tube 1.

In this way, if any intestinal fluid that has permeated through the first balloon 12 is present, it can be blocked by the auxiliary balloon 15. And the intestinal juice is led into the drainage cavity tube 6 through the drainage hole 16 between the first saccule 12 and the auxiliary saccule 15 to be led out of the body, so that the risk of leakage of the intestinal juice to the anastomotic stoma can be better reduced by the design.

In the figure, the first balloon 12 and the second balloon 15 are filled or pumped by the same communicating tube 122, but it is also possible to use different communicating tubes for filling or pumping.

It should be understood that although the present disclosure describes embodiments, not every embodiment is provided with a separate embodiment, and that this description is provided for clarity only, and that the disclosure is not limited to specific embodiments, and that the embodiments may be combined appropriately to form other embodiments that will be understood by those skilled in the art.

The above embodiments are only preferred embodiments of the present invention, and are not intended to limit the present invention, but all modifications, substitutions or improvements within the spirit and principles and scope of the present invention are within the scope of the present invention.

Claims

1. The utility model provides an ileostomy tube, includes the pipe body, its characterized in that is equipped with first sacculus (12) on the lower extreme outer wall of pipe body (1), in the hypomere of pipe body, is equipped with supplementary sacculus (15) on the upper portion that is located first sacculus (12), the outer wall of one section pipe body between supplementary sacculus (15) and first sacculus (12) is equipped with drainage hole (16), drainage hole intercommunication drainage lumen (6).